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P2. Concurrent intramedullary cervical spine abscess and intraventricular empyema P2。并发髓内颈椎脓肿和脑室脓肿
North American Spine Society Journal Pub Date : 2025-07-01 DOI: 10.1016/j.xnsj.2025.100626
Shao Lun Chen MD
{"title":"P2. Concurrent intramedullary cervical spine abscess and intraventricular empyema","authors":"Shao Lun Chen MD","doi":"10.1016/j.xnsj.2025.100626","DOIUrl":"10.1016/j.xnsj.2025.100626","url":null,"abstract":"<div><h3>BACKGROUND CONTEXT</h3><div>Intramedullary spinal cord abscess (ISCA) and intraventricular empyema are both rare, severe infections that can result in significant neurological impairment or death if not managed promptly. Although each condition alone poses diagnostic and therapeutic challenges, the simultaneous occurrence of ISCA and intraventricular empyema is exceedingly uncommon. Recognizing these pathologies early and initiating aggressive treatment is essential to prevent irreversible CNS damage.</div></div><div><h3>PURPOSE</h3><div>To present a rare case of concurrent cervical intramedullary spinal cord abscess and intraventricular empyema, highlighting the diagnostic difficulties, the necessity of early surgical intervention, and the importance of comprehensive antibiotic coverage in managing complex central nervous system infections.</div></div><div><h3>STUDY DESIGN/SETTING</h3><div>This is a single-patient case report treated at a tertiary neurosurgical center, coupled with a review of the pertinent literature to contextualize the rarity and management of such concurrent CNS infections.</div></div><div><h3>PATIENT SAMPLE</h3><div>A 43-year-old female patient, with a history of cervical spine surgery (for ossification of the posterior longitudinal ligament), presented with a two-week history of fever, acute left upper limb weakness, numbness, and neck pain.</div></div><div><h3>OUTCOME MEASURES</h3><div>Key measures included neurological status (motor strength, level of consciousness), radiological evolution of the spinal and intraventricular infections (MRI findings), and response to antimicrobial therapy and surgical interventions (abscess drainage, external ventricular drainage, and shunt placement).</div></div><div><h3>METHODS</h3><div>An urgent surgical decompression and drainage of the intramedullary abscess at the C3–4 level was performed via a posterior approach. Antibiotics were initially broad-spectrum, then tailored to culture results identifying oral flora (Prevotella species and Fusobacterium nucleatum). When the patient’s mental status worsened, follow-up brain imaging revealed intraventricular empyema, requiring external ventricular drainage. After infection control was achieved, ventriculoperitoneal shunts were placed to address persistent hydrocephalus.</div></div><div><h3>RESULTS</h3><div>Despite initial deterioration in motor strength post-surgery, the patient demonstrated gradual neurological improvement with appropriate antibiotic therapy and serial interventions for both the spinal cord abscess and the intraventricular empyema. Final discharge status showed partial but meaningful recovery of left-sided strength, normal alertness, and resolution of severe headaches attributed to hydrocephalus.</div></div><div><h3>CONCLUSIONS</h3><div>Concurrent spinal cord abscess and intraventricular empyema demand high clinical suspicion and a coordinated, multidisciplinary approach. Early recognition, comprehensive antibiot","PeriodicalId":34622,"journal":{"name":"North American Spine Society Journal","volume":"22 ","pages":"Article 100626"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144672512","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
P7. Clinical and radiologic outcomes of the use of interlaminar device (Coflex®) among patients with low-grade lumbar spondylolisthesis: a single center study 第七页。轻度腰椎滑脱患者使用椎板间装置(Coflex®)的临床和放射学结果:一项单中心研究
North American Spine Society Journal Pub Date : 2025-07-01 DOI: 10.1016/j.xnsj.2025.100631
Katrina Ysabel Naraval MD , Mikhail Lew Perez Ver MD
{"title":"P7. Clinical and radiologic outcomes of the use of interlaminar device (Coflex®) among patients with low-grade lumbar spondylolisthesis: a single center study","authors":"Katrina Ysabel Naraval MD , Mikhail Lew Perez Ver MD","doi":"10.1016/j.xnsj.2025.100631","DOIUrl":"10.1016/j.xnsj.2025.100631","url":null,"abstract":"<div><h3>BACKGROUND CONTEXT</h3><div>Lumbar spinal fusion relieves pain in degenerative spondylolisthesis (DLS) but carries postoperative risks, including pseudoarthrosis and adjacent segment degeneration and disease, which may eventually lead to reoperation. Dynamic stabilizers, like Coflex® interlaminar device, preserve motion while ensuring stability, providing symptom relief with fewer complications and a reduced risk profile. Though research varies, recent studies highlight their benefits in low-grade DLS.</div></div><div><h3>PURPOSE</h3><div>This study evaluated the radiologic and clinical effectiveness of Coflex® after decompression for low-grade DLS, with follow-ups at 1 to up to 6 years to assess outcomes and complications.</div></div><div><h3>STUDY DESIGN/SETTING</h3><div>This is an analytical retrospective cohort study from a single tertiary center including patients who had low-grade spondylolisthesis (Meyerding Gr I) and was treated with lumbar decompression with consequent interlaminar device (Coflex®) application performed by two fellowship-trained spine surgeons between January 1, 2017 and June 31, 2023. Ethical clearance was obtained (SL-23278).</div></div><div><h3>PATIENT SAMPLE</h3><div>Forty-seven patients who had low-grade spondylolisthesis (Meyerding Gr I) and treated with lumbar decompression with consequent interlaminar device (Coflex®) application were included.</div></div><div><h3>OUTCOME MEASURES</h3><div>Radiographic parameters – lumbar lordosis (LL), lower lumbar lordosis (LLL), intervertebral disc height (IDH), intervertebral foramen height (IFH), and vertebral translation (VT) – were obtained. Clinical outcomes were evaluated by visual analogue scale (VAS) and Oswestry disability Index (ODI).</div></div><div><h3>METHODS</h3><div>Primary outcomes were categorized as radiographic and clinical. Radiographic parameters and functional outcomes included were assessed preoperatively, postoperatively, at 1-year follow-up, and at =1-year follow-up. Descriptive statistics (mean, range, SD, frequency, percentage) were calculated. A paired Student*s t-test assessed differences in radiographic parameters and clinical outcomes. Comparisons were made across preoperative, immediate postoperative, 12-month follow-up, and latest follow-up (=1 year). Linear mixed model analysis with compound symmetry evaluated significant changes over time. Statistical significance was set at p< 0.05.</div></div><div><h3>RESULTS</h3><div>A total of 47 patients (mean age 57 years, range 30-92) with 50 implanted levels were included in the study. Following surgical decompression and interlaminar device placement, LL showed a slight but non-significant decrease [42.89° ± 10.08 to 40.33° ± 8.30 (p = 0.059)] and remained stable, while LLL remained unchanged. VT improved significantly from 3.82 mm ± 3.66 mm to 1.53 mm ± 1.84 mm (p < 0.001) and remained stable until the final follow-up (p = 0.922). IDH increased significantly from 10.23 mm ± 2.33 to 12","PeriodicalId":34622,"journal":{"name":"North American Spine Society Journal","volume":"22 ","pages":"Article 100631"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144672553","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
13. Association between dynamic instability and muscle health change in patients with L4-5 degenerative Grade I spondylolisthesis and operative spinal stenosis 13. L4-5退行性I级椎体滑脱和椎管狭窄患者的动力不稳定性与肌肉健康变化的关系
North American Spine Society Journal Pub Date : 2025-07-01 DOI: 10.1016/j.xnsj.2025.100707
Taha Khalilullah BS, Ripul R. Panchal DO, FACS
{"title":"13. Association between dynamic instability and muscle health change in patients with L4-5 degenerative Grade I spondylolisthesis and operative spinal stenosis","authors":"Taha Khalilullah BS, Ripul R. Panchal DO, FACS","doi":"10.1016/j.xnsj.2025.100707","DOIUrl":"10.1016/j.xnsj.2025.100707","url":null,"abstract":"<div><h3>BACKGROUND CONTEXT</h3><div>Degenerative spondylolisthesis at the L4-5 level is a prevalent spinal condition often requiring surgery. Chronic low back pain has been strongly associated with paraspinal muscle deterioration, including multifidus atrophy, and poorer muscle health has been linked to decreased quality of life. However, the connection between muscle degeneration and lumbar spine instability remains unclear, with contributing factors likely including age, altered biomechanics, and activity levels. Degenerative spondylolisthesis at L4-5 often requires surgery and is linked to paraspinal muscle atrophy and reduced quality of life. However, the impact of instability and alignment changes on muscle health remains unclear, particularly in severe cases. This study aims to address these gaps by investigating muscle health using advanced metrics to better understand its relationship with spondylolisthesis.</div></div><div><h3>PURPOSE</h3><div>This study aims to investigate the association between dynamic instability and muscle health changes in patients with Grade 1 L4-5 degenerative spondylolisthesis and operative spinal stenosis, enhancing our understanding of the pathophysiology of spondylolisthesis.</div></div><div><h3>STUDY DESIGN/SETTING</h3><div>Single-center retrospective cohort study.</div></div><div><h3>PATIENT SAMPLE</h3><div>The study cohort consisted of patients diagnosed with L4-5 spinal stenosis who underwent surgical intervention at the L4-5 level. The cohort was further stratified into two groups: those with L4-5 grade 1 spondylolisthesis and those without spondylolisthesis.</div></div><div><h3>OUTCOME MEASURES</h3><div>Difference in lumbar lordosis, L4-5 Cobb angle, anterior disc height, posterior disc height between flexion and extension, Goutallier classification, lumbar indentation value, BMI, and L4-5 paraspinal and psoas cross sectional area.</div></div><div><h3>METHODS</h3><div>Descriptive statistics were employed to determine L4-5 grade 1 spondylolisthesis, L4-5 spinal stenosis, and surgery involving the L4-5 intervertebral level. Patients were subdivided based on the presence of spondylolisthesis. Cross-sectional area normalized by body mass index (CSA/BMI) was quantified using ImageJ software. Measurement of lumbar lordosis, Cobb angle, and lumbar indentation value were recorded by radiographs. Statistical analysis was conducted using independent Student's t-test and bivariate analysis to compare the groups.</div></div><div><h3>RESULTS</h3><div>There were 101 patients included in our analysis. Fifty-two patients had Grade 1 degenerative spondylolisthesis. The spondylolisthesis group presented with significantly greater L4-5 lordosis in extension compared to the group without spondylolisthesis (23.69 ± 10.62 vs 20.22 ± 7.92, p = .044). However, the spondylolisthesis group also presented with significantly worse anterolisthesis in flexion (7.21 ± 3.66 vs 10.14 ± 23.53, p = .0002). There was no significant diffe","PeriodicalId":34622,"journal":{"name":"North American Spine Society Journal","volume":"22 ","pages":"Article 100707"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144672407","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
34. Postoperative changes in pelvic indices after MIS-TLIF for lumbar spondylolisthesis: retrospective analysis 34. miss - tlif治疗腰椎滑脱术后骨盆指数的变化:回顾性分析
North American Spine Society Journal Pub Date : 2025-07-01 DOI: 10.1016/j.xnsj.2025.100728
Shrey Binyala MS, DNB
{"title":"34. Postoperative changes in pelvic indices after MIS-TLIF for lumbar spondylolisthesis: retrospective analysis","authors":"Shrey Binyala MS, DNB","doi":"10.1016/j.xnsj.2025.100728","DOIUrl":"10.1016/j.xnsj.2025.100728","url":null,"abstract":"<div><h3>BACKGROUND CONTEXT</h3><div>Lumbar spondylolisthesis often results in pelvic imbalance, contributing to chronic pain and disability. Minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) has emerged as an effective surgical option, offering stabilization and correction of spinal alignment with reduced tissue disruption.</div></div><div><h3>PURPOSE</h3><div>This retrospective study evaluates postoperative improvements in pelvic indices, including pelvic incidence (PI), pelvic tilt (PT), sacral slope (SS), and lumbar lordosis (LL), in patients with lumbar spondylolisthesis treated with MIS-TLIF.</div></div><div><h3>STUDY DESIGN/SETTING</h3><div>The study design is retrospective. It involves reviewing and analyzing the medical records and radiographic data of patients who underwent MIS-TLIF for lumbar spondylolisthesis between 2018 and 2024. The study examines preoperative and postoperative changes in pelvic indices and their correlation with clinical outcomes.</div></div><div><h3>PATIENT SAMPLE</h3><div>A total of 354 patients were included in this retrospective study.</div></div><div><h3>OUTCOME MEASURES</h3><div>Pelvic Indices: PI, PT, SS, LL. Preoperative and postoperative changes in these parameters were assessed through radiographic imaging. Clinical Outcomes: pain levels, assessed using a visual analog scale (VAS) preoperatively and postoperatively. Functional improvements, measured using the Oswestry Disability Index (ODI) or a similar functional assessment tool. Sagittal Alignment: improvement in overall spinal sagittal balance, evaluated through radiographic measurements and clinical examination. Correlation between radiographic and clinical outcomes: The relationship between improvements in pelvic indices and clinical improvements in pain and function was analyzed. Complications: any intraoperative or postoperative complications, such as infection or hardware failure, were documented.</div></div><div><h3>METHODS</h3><div>This is a retrospective study involving patients who underwent MIS-TLIF for lumbar spondylolisthesis between 2018 and 2024. The following steps were involved: Patient Selection: inclusion criteria: patients diagnosed with lumbar spondylolisthesis who underwent MIS-TLIF surgery. Exclusion criteria: patients with incomplete clinical or radiographic data or those who had additional spine surgeries outside the MIS-TLIF approach. Radiographic Analysis: Preoperative and postoperative radiographs (x-rays or CT scans) were reviewed to measure key pelvic parameters, including: PI, PT, SS, LL. Changes in these pelvic indices were analyzed to evaluate improvements in sagittal alignment. Clinical Outcome Assessment: Pain Assessment: pain levels were measured using the VAS preoperatively and at follow-up intervals. Functional Outcome: Functional improvements were assessed using the ODI or other relevant clinical scoring tools. Follow-up: Patients were followed up at regular intervals (eg, 1, 3, and 6 months; 1,","PeriodicalId":34622,"journal":{"name":"North American Spine Society Journal","volume":"22 ","pages":"Article 100728"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144672411","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
25. Evaluation of 3D-printed porous titanium alloy versus polyetheretherketone cages in the surgical treatment of multilevel cervical degenerative disease 25. 3d打印多孔钛合金与聚醚醚酮笼在多节段宫颈退行性疾病手术治疗中的比较
North American Spine Society Journal Pub Date : 2025-07-01 DOI: 10.1016/j.xnsj.2025.100719
Taha Khalilullah BS , Ripul R. Panchal DO, FACS , Pratibha Nayak PhD, MBA, MPH
{"title":"25. Evaluation of 3D-printed porous titanium alloy versus polyetheretherketone cages in the surgical treatment of multilevel cervical degenerative disease","authors":"Taha Khalilullah BS , Ripul R. Panchal DO, FACS , Pratibha Nayak PhD, MBA, MPH","doi":"10.1016/j.xnsj.2025.100719","DOIUrl":"10.1016/j.xnsj.2025.100719","url":null,"abstract":"<div><h3>BACKGROUND CONTEXT</h3><div>Anterior cervical discectomy and fusion (ACDF) with 3D-printed titanium (TTN) or polyetheretherketone (PEEK) cages is an effective surgery for patients with cervical radiculopathy/myelopathy. The advent of 3D-printed porous TTN cages and its microporous structure has contributed to diminished subsidence and improved osseointegration compared to PEEK. This study compares the long-term outcomes of both implants among patients who underwent a multilevel ACDF procedure.</div></div><div><h3>PURPOSE</h3><div>To compare the long-term clinical and radiographic outcomes of patients who have undergone multilevel ACDF with either 3D-printed TTN or PEEK cages with level-specific analysis.</div></div><div><h3>STUDY DESIGN/SETTING</h3><div>Single-center retrospective cohort study.</div></div><div><h3>PATIENT SAMPLE</h3><div>Patients who underwent multilevel ACDF procedure with PEEK and 3D Titanium implants.</div></div><div><h3>OUTCOME MEASURES</h3><div>Radiographic outcomes for fusion, cage migration, and subsidence were determined with cervical x-rays and sub-analyzed by the caudal and rostral vertebral level.</div></div><div><h3>METHODS</h3><div>In total, 96 patients underwent multilevel (2, 3, 4) ACDF surgery, of whom 66 and 30 received a PEEK and 3D-printed TTN interbody cage, respectively. Radiographic outcomes for fusion, cage migration, and subsidence were determined with cervical x-rays and analyzed with independent 2-sample T-test and <strong>χ</strong><sup>2</sup> test. Visual analog score (VAS) and Neck Disability Index (NDI) score were examined with repeated measure analysis of variance.</div></div><div><h3>RESULTS</h3><div>Of the 96 patients included, 66 (69%) were in the PEEK group and 30 (31%) in the 3D-printed TTN group. Baseline demographics, including age, osteoporosis, smoking status, and preoperative NDI and VAS scores, were similar between groups. Intraoperative variables, such as blood loss and levels operated, also showed no significant differences. Postoperatively, the 3D-printed TTN group showed a trend of lower NDI and VAS scores at 6 months and 1 year, with significantly improved NDI scores at 1 year (p = .017). Fusion rates were comparable across groups at proximal levels for 2-, 3-, and 4-level ACDFs, with the 3D-printed TTN group demonstrating significantly shorter time to fusion at the distal level of 3-level procedures (p = .011). Complications included dysphagia (15.2% PEEK vs 23.3% TTN), screw loosening, and subsidence, which was more frequent in the 3D-printed TTN group (20% vs 3.33%). Pseudarthrosis was most common at distal levels, but no reoperations occurred in either group. Fusion outcomes were comparable at most levels, but distal-level challenges persisted.</div></div><div><h3>CONCLUSIONS</h3><div>The use of 3D-printed TTN implants enhanced the time to bony fusion at distal levels relative to PEEK cages. Clinically, patients with 3D-printed TTN implants reported diminished NDI score","PeriodicalId":34622,"journal":{"name":"North American Spine Society Journal","volume":"22 ","pages":"Article 100719"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144672446","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
P33. Clinical oversight and delayed diagnosis of a pathological compression fracture causing paraplegia P33。病理性压缩性骨折导致截瘫的临床疏忽和延迟诊断
North American Spine Society Journal Pub Date : 2025-07-01 DOI: 10.1016/j.xnsj.2025.100657
Yin-Sheng Chen MD, Chao-Hung Kuo MD, PhD
{"title":"P33. Clinical oversight and delayed diagnosis of a pathological compression fracture causing paraplegia","authors":"Yin-Sheng Chen MD, Chao-Hung Kuo MD, PhD","doi":"10.1016/j.xnsj.2025.100657","DOIUrl":"10.1016/j.xnsj.2025.100657","url":null,"abstract":"","PeriodicalId":34622,"journal":{"name":"North American Spine Society Journal","volume":"22 ","pages":"Article 100657"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144672515","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
8. Pedicle bone quality score offers superior predictive value over vertebral bone quality score for pedicle screw loosening following instrumented transforaminal lumbar interbody fusion: an MRI-based study 8. 椎弓根骨质量评分对经椎间孔腰椎椎体间融合术后椎弓根螺钉松动的预测价值优于椎体骨质量评分:基于mri的研究
North American Spine Society Journal Pub Date : 2025-07-01 DOI: 10.1016/j.xnsj.2025.100702
An-Jhih Luo MD, Yu-Cheng Yeh MD, Yung Hsueh Hu MD
{"title":"8. Pedicle bone quality score offers superior predictive value over vertebral bone quality score for pedicle screw loosening following instrumented transforaminal lumbar interbody fusion: an MRI-based study","authors":"An-Jhih Luo MD, Yu-Cheng Yeh MD, Yung Hsueh Hu MD","doi":"10.1016/j.xnsj.2025.100702","DOIUrl":"10.1016/j.xnsj.2025.100702","url":null,"abstract":"<div><h3>BACKGROUND CONTEXT</h3><div>Pedicle screw loosening (PSL) is a common complication in transforaminal lumbar interbody fusion (TLIF), leading to poor clinical outcomes such as pseudarthrosis, adjacent segment pathology, and spinal instability, often necessitating revision surgeries. Bone quality significantly impacts screw stability, traditionally assessed through computed tomography (CT) or dual-energy X-ray absorptiometry (DEXA). However, magnetic resonance imaging (MRI)-based pedicle bone quality (PBQ) and vertebral bone quality (VBQ) scores offer non-ionizing alternatives for preoperative bone quality evaluation.</div></div><div><h3>PURPOSE</h3><div>To compare the predictive strength of PBQ and VBQ scores for assessing PSL following TLIF and to identify key risk factors contributing to screw loosening.</div></div><div><h3>STUDY DESIGN/SETTING</h3><div>A retrospective cohort study evaluating MRI-derived PBQ and VBQ scores as predictors of PSL in patients undergoing TLIF.</div></div><div><h3>PATIENT SAMPLE</h3><div>A total of 394 patients (aged ≥ 18) were treated with TLIF for degenerative lumbar spinal conditions, with complete preoperative imaging and at least 12 months of postoperative follow-up.</div></div><div><h3>OUTCOME MEASURES</h3><div>Primary outcomes included the incidence of PSL and the predictive accuracy of PBQ and VBQ scores. Secondary measures included fusion rates, T-scores from DEXA, and patient-reported outcomes such as the visual analog scale (VAS) and Oswestry Disability Index (ODI).</div></div><div><h3>METHODS</h3><div>PBQ and VBQ scores were calculated from sagittal T1-weighted MRI images and normalized against cerebrospinal fluid intensity. Receiver operating characteristic (ROC) curves and area under the curve (AUC) values compared their predictive efficacy. Multivariate logistic regression identified independent risk factors for PSL.</div></div><div><h3>RESULTS</h3><div>PBQ exhibited superior predictive accuracy for PSL compared to VBQ (AUC: 0.894 vs 0.722). PBQ demonstrated higher sensitivity (75.93%), specificity (92.31%), positive predictive value (78.85%), and negative predictive value (91.03%). Significant predictors of PSL included higher PBQ scores, longer fusion constructs, lower T-scores, reduced fusion rates, and older age. PSL was associated with increased back pain but did not significantly impact ODI or leg VAS scores.</div></div><div><h3>CONCLUSIONS</h3><div>PBQ scores are stronger predictors of PSL than VBQ, providing a valuable non-ionizing alternative for preoperative assessment. Integration of PBQ scores into surgical planning may optimize screw fixation strategies, particularly in patients with compromised bone quality. Additional significant risk factors for screw loosening included older age, lower hip DEXA T-scores, longer fusion constructs, and lower fusion rates.</div></div><div><h3>FDA Device/Drug Status</h3><div>This abstract does not discuss or include any applicable devices or drugs.","PeriodicalId":34622,"journal":{"name":"North American Spine Society Journal","volume":"22 ","pages":"Article 100702"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144672549","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
11. Ten-year outcomes following intradiscal interventions: no accelerated degeneration in punctured discs with sustained long-term benefits 11. 椎间盘内干预后的10年结果:穿刺椎间盘无加速退变,具有持续的长期益处
North American Spine Society Journal Pub Date : 2025-07-01 DOI: 10.1016/j.xnsj.2025.100705
Andreas Veihelmann MD, PhD
{"title":"11. Ten-year outcomes following intradiscal interventions: no accelerated degeneration in punctured discs with sustained long-term benefits","authors":"Andreas Veihelmann MD, PhD","doi":"10.1016/j.xnsj.2025.100705","DOIUrl":"10.1016/j.xnsj.2025.100705","url":null,"abstract":"<div><h3>BACKGROUND CONTEXT</h3><div>Intradiscal interventions and discography for managing discogenic pain or disc protrusions with radicular symptoms remain controversial. Notably, a study by Carragee et al suggested that puncturing healthy discs accelerates their degeneration.</div></div><div><h3>PURPOSE</h3><div>This study aimed to evaluate long-term outcomes 10 years after intradiscal interventions such as discography, intradiscal electrothermal therapy, and intradiscal volume reduction.</div></div><div><h3>STUDY DESIGN/SETTING</h3><div>Retrospective clinical observational trial.</div></div><div><h3>PATIENT SAMPLE</h3><div>We contacted 162 patients who underwent discography or intradiscal procedures between 2009 and 2013, of which we were abel to achieve n=50 for complete assessment.</div></div><div><h3>OUTCOME MEASURES</h3><div>Pre- and postprocedure MRIs (approximately 10 years apart) of the lumbar spine were analyzed. Long-term outcomes were also measured using the Numeric Rating Scale (NRS), Oswestry Disability Index (ODI), and SF-36 at the 10-year follow-up.</div></div><div><h3>METHODS</h3><div>Disc degeneration was assessed using the Pfirrmann classification and compared within the same disc over time and against a neighboring nonpunctured disc. Evaluations using the Pfirrmann classification were performed independently by an experienced MRI radiologist and a spine surgeon, with intra- and inter-rater reliability assessed.</div></div><div><h3>RESULTS</h3><div>Of the 121 patients contacted, 50 met the inclusion and exclusion criteria (30 underwent lumbar spine surgery; 41 could not participate due to general health reasons). High intra- and inter-rater reliability was observed in disc degeneration assessments. Both punctured and nonpunctured discs showed significant degeneration over 9–10 years. However, there was no statistically significant difference in the rate of degeneration between punctured and nonpunctured discs. Intraindividual comparisons yielded similar results. Puncture size (22-gauge for discography and 17-gauge for intradiscal procedures) did not significantly influence outcomes. NRS, ODI, and SF-36 scores demonstrated significant improvement 10 years post-procedure.</div></div><div><h3>CONCLUSIONS</h3><div>In this cohort, no evidence of accelerated degeneration in punctured discs was observed over 10 years. Intradiscal procedures were safe and provided significant, sustained improvements in pain and disability scores across all measured parameters.</div></div><div><h3>FDA Device/Drug Status</h3><div>This abstract does not discuss or include any applicable devices or drugs.</div></div>","PeriodicalId":34622,"journal":{"name":"North American Spine Society Journal","volume":"22 ","pages":"Article 100705"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144672605","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
17. Over 10 years mean follow up results of Hemivertebra Resection and Spine Arthrodesis by Single-Stage Posterior Approach in Congenital Scoliosis and Kyphoscoliosis 17. 单期后路半椎体切除和脊柱融合术治疗先天性脊柱侧凸和后凸型脊柱侧凸的平均随访时间超过10年
North American Spine Society Journal Pub Date : 2025-07-01 DOI: 10.1016/j.xnsj.2025.100711
Osvaldo Mazza
{"title":"17. Over 10 years mean follow up results of Hemivertebra Resection and Spine Arthrodesis by Single-Stage Posterior Approach in Congenital Scoliosis and Kyphoscoliosis","authors":"Osvaldo Mazza","doi":"10.1016/j.xnsj.2025.100711","DOIUrl":"10.1016/j.xnsj.2025.100711","url":null,"abstract":"","PeriodicalId":34622,"journal":{"name":"North American Spine Society Journal","volume":"22 ","pages":"Article 100711"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144672609","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
46. Long-term benefits of percutaneous endoscopic discectomy versus open discectomy: reduced risk of spinal fusion and insights across patient subgroups from the real world global collaborative network 46. 经皮内窥镜椎间盘切除术与开放椎间盘切除术的长期益处:降低脊柱融合的风险和来自现实世界全球协作网络的患者亚组的见解
North American Spine Society Journal Pub Date : 2025-07-01 DOI: 10.1016/j.xnsj.2025.100740
Sung Huang Laurent Tsai MD , Mohamad Bydon MD
{"title":"46. Long-term benefits of percutaneous endoscopic discectomy versus open discectomy: reduced risk of spinal fusion and insights across patient subgroups from the real world global collaborative network","authors":"Sung Huang Laurent Tsai MD ,&nbsp;Mohamad Bydon MD","doi":"10.1016/j.xnsj.2025.100740","DOIUrl":"10.1016/j.xnsj.2025.100740","url":null,"abstract":"<div><h3>BACKGROUND CONTEXT</h3><div>The choice between percutaneous endoscopic lumbar discectomy (PELD) and open lumbar discectomy (OLD) for managing lumbar disc herniation (LDH) remains debated. While both techniques achieve comparable short-term outcomes, their long-term effects, particularly regarding the progression to spinal fusion, are underexplored. This study evaluates the risk of subsequent spinal fusion associated with PELD versus OLD and examines how patient demographics and comorbidities influence these outcomes.</div></div><div><h3>PURPOSE</h3><div>This study evaluates the long-term risk of spinal fusion following PELD versus OLD, with a focus on subgroup-specific differences, including age, race, BMI, and comorbidities.</div></div><div><h3>STUDY DESIGN/SETTING</h3><div>Retrospective cohort study.</div></div><div><h3>PATIENT SAMPLE</h3><div>The study included 123,405 patients diagnosed with lumbar disc herniation (LDH) from the TriNetX Research Network. After applying inclusion and exclusion criteria: PELD Group: 93,853 patients undergoing PELD. OLD Group: 29,552 patients undergoing OLD. Following propensity score matching (1:1) to balance baseline characteristics, the final analysis included 29,552 matched pairs (total: 59,104 patients). These patients were followed for up to 20 years to assess the risk of subsequent spinal fusion.</div></div><div><h3>OUTCOME MEASURES</h3><div>Primary Outcome: Subsequent Spinal Fusion: Defined as any spinal fusion procedure performed after the index discectomy (PELD or OLD). Identified using ICD-10-PCS and ICD-9 procedure codes (eg, 0SG0070, 81.00, 81.04–81.08, etc.). Secondary Outcomes: Cumulative Incidence of Spinal Fusion: Analyzed using Kaplan-Meier survival curves over a 20-year follow-up period. Subgroup Outcomes: Stratified analysis of spinal fusion risk based on: Demographics: Age (20–45, 46–59, =60 years), gender, race. Lifestyle Factors: Smoking, alcohol-related disorders. Clinical Conditions: Comorbidities such as spinal stenosis, spondylolisthesis, ischemic heart disease, scoliosis, COPD, CKD, and BMI =30 kg/m². Statistical Significance: Hazard ratios (HR) for spinal fusion were calculated using Cox proportional hazards models, with a significance threshold of p &lt; 0.05.</div></div><div><h3>METHODS</h3><div>Using the TriNetX Research Network, we analyzed data from 123,405 patients diagnosed with LDH between 2000 and 2023, including 93,853 PELD and 29,552 OLD cases. After propensity score matching, a 1:1 cohort was created to ensure baseline comparability. Patients were followed for up to 20 years to assess the risk of subsequent spinal fusion. Kaplan-Meier survival analyses and Cox proportional hazard models were employed to estimate hazard ratios (HR) and evaluate subgroup outcomes.</div></div><div><h3>RESULTS</h3><div>PELD significantly reduced the risk of spinal fusion compared to OLD over a 20-year follow-up (HR 0.706; 95% CI: 0.656–0.760). Subgroup analysis revealed consistent be","PeriodicalId":34622,"journal":{"name":"North American Spine Society Journal","volume":"22 ","pages":"Article 100740"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144672418","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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